Quality improvement of neuro-oncology services: integrating the routine collection of patient-reported, health-related quality-of-life measures
Research output: Contribution to journal › Review article › peer-review
Colleges, School and Institutes
- Department of Clinical Neurosciences, Cambridge Centre for Brain Repair, University of Cambridge, Cambridge, CB2 0PY, UK; Division of Neurosurgery, Department of Clinical Neurosciences, University of Cambridge, Addenbrooke's Hospital, Cambridge, CB2 0QQ, UK.
- Neurosurgery Department, Cambridge University Hospitals NHS Trust, Addenbrookes Hospital, UK.
- Department of Neurosurgery, The Walton Centre NHS Foundation Trust, Lower Lane, Liverpool, Merseyside, UK, L9 7LJ.
Background: Brain cancer has a strong impact on health-related quality of life (HRQoL), and its evaluation in clinical practice can improve the quality of care provided. The aim of this project was to integrate routine collection of HRQoL information from patients with brain tumor or metastasis in 2 specialized United Kingdom tertiary centers, and to evaluate the implementation process.
Methods: Since October 2016, routine collection of electronic self-reported HRQoL information has been progressively embedded in the participating centers using standard questionnaires. During the first year, the project was implemented, and the process evaluated, through regular cycles of process evaluation followed by an action plan, monitoring of questionnaire completion rates, and assessment of patient views.
Results: Main challenges encountered included reluctance to change usual practice and limited resources. Key measures for success included strong leadership of senior staff, involvement of stakeholders in project design and evaluation, and continuous strategic support to professionals. Final project workflow included 6 process steps, 1 decision step, and 4 outputs. Questionnaires were mostly self-completed (75.1%), and completion took 6-9 minutes. Most patients agreed that the questionnaire items were easy to understand (97.0%), important for them (93.0%), and helped them think what they wanted to discuss in their clinical consultation (75.4%).
Conclusions: Integrating HRQoL information as a routine part of clinical assessments has the potential to enhance individually tailored patient care in our institutions. Challenges involved in innovations of this nature can be overcome through a systematic approach involving strong leadership, wide stakeholder engagement, and strategic planning.
|Number of pages||11|
|Early online date||17 Oct 2018|
|Publication status||Published - 1 Jun 2019|
- brain tumors, process evaluation, quality improvement, quality of life, Quality improvement, Brain tumors, Process evaluation, Quality of life